Combined Hyperactive Dysfunction Syndrome of the Cranial Nerves: A retrospective systematic study of clinical characteristics in 44 patients.

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Combined Hyperactive Dysfunction Syndrome of the Cranial Nerves: A retrospective systematic study of clinical characteristics in 44 patients.

World Neurosurg. 2017 May 13;:

Authors: Cao J, Jiao J, Du Z, Xu W, Sun B, Li F, Liu Y

Abstract
BACKGROUND: Combined hyperactive dysfunction syndrome (HDS) is defined as the combination symptoms arising from overactivity in cranial nerves specifically, trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN) without an obvious explanatory structural lesion. The study aims to retrospectively analyze the clinical characteristics of combined HDS treated with microvascular decompression (MVD) in a single institution.
METHODS: A total of 1450 patients with HDS were treated with MVD in our department during a 10-year period, among which 44 cases of combined HDS were identified. Clinical records and follow-ups were reviewed.
RESULTS: Combined HDS comprised 3.03% (44/1450) of all HDS in our series, with female predominance compared with single HDS (p=0.002), including combined TN-HFS (14 cases), combined TN-GPN (26 cases), bilateral TN (2 cases), and combined TN-HFS-GPN (2 cases). The average age at diagnosis of combined HDS (60.9 y) was significantly older than that of single HDS (53.5 y), p=0.035. Hypertension was closely associated with the prevalence of combined HDS compared with single HDS (p=0.009). The curative rate was 97.7% (43/44) after MVD, and the recurrence rate was 3.33%. The incidence rates of postoperative cardiac, pulmonary, thromboembolic, and delirium complications were higher in combined HDS than in single HDS (p<0.05).
CONCLUSIONS: Combined HDS is a rarely occurring syndrome usually observed in older females, and the most common types are combined TN-GPN and combined TN-HFS. Age and gender seemed to be etiologic factors for developing combined HDS, MVD shows potential as a favorable treatment choice.

PMID: 28512048 [PubMed - as supplied by publisher]

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